CMS Price Transparency Data

Group therapy session

Facility: Larkin Community Hospital Behavioral Health Srvs

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $250
Cash Discount Price: $753
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Larkin Community Hospital Behavioral Health Srvs is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $753. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.41x the Medicare baseline. Located in 1201 N 37Th Ave, Hollywood, FL.

Cash / Self-Pay

$753

Average discount available for prompt cash payment at this facility.

Insurance Median

$250

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$103.79

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $103.79 (100%)

Cash / Self-Pay: $753 (726%)

Insurance Median: $250 (241%)

Cash: $753 (726% of Medicare)

Ins. Median: $250 (241% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $103.79 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 241% of the Medicare baseline (a markup of 141%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Bright Hlth Mcr Adv	$92	89%
Doctors Healthcare-All Plans	$120 - $200	116%
Sunshine Behav Mcaid	$133 - $250	128%
Medicaid / KanCare	$137	132%
Miami Childrens Hp-All Plans	$137	132%
Sunshine Behav Comm - All Other Plans	$140 - $403	135%
Community Care Plan-All Plans	$150 - $200	145%
Concordia Behav Health - All Plans	$150 - $200	145%
Fcc-All Other Plans	$150 - $200	145%
Humana	$150 - $250	145%
New Directions-All Plans	$150 - $250	145%
Wellcare Of Fl-All Plans	$175 - $250	169%
Magellan Healthcare-All Plans	$258 - $1,033	249%
Cigna	$301 - $1,205	290%
United Behavioral Health Adult - All Other Plans	$350 - $450	337%
United Behavioral Health Adolescent	$385 - $495	371%
Longevity Mcr Adv-All Plans	$403 - $1,614	388%
Clear Spring Health-All Plans	$423 - $1,694	408%
Aetna	$430 - $1,721	414%
Hma Mcr Adv	$464 - $1,856	447%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $753.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Larkin Community Hospital Behavioral Health Srvs is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.